According to the National Survey of Counseling Center Directors, 85% of counseling center directors surveyed reported an increase in severe psychological problems among students over the past five years (Gallagher et al., 2001). More than half of counselors polled in the 2001 survey of 274 colleges and universities said the prevalence of self-injury had increased over the same period.
For every completed suicide, there are untold numbers of suicide attempts and an even larger pool of individuals who have considered suicide. According to the National College Health Risk Behavior Survey, 10.3% of college students had seriously considered ending their own lives during the preceding 12 months (CDC, 1997). Even more chilling, 6.7% of students actually made suicide plans. Yet only 17.6% of college students nationwide reported that they had received information on suicide prevention from their institution.
The transition to college life can be challenging under the best of circumstances. Students, many of whom may be leaving home for the first time, are being exposed to new freedoms and new responsibilities simultaneously. Academic and social pressures can be overwhelming.
"I think there is that pressure, especially in the freshman year, when there's initial anxiety that's going to settle out," Michael Craig Miller, M.D., assistant professor of psychiatry at Harvard Medical School and editor-in-chief of The Harvard Mental Health Letter, told PT. "They need help with the transition and once they make it, it's quite successful."
Unfortunately, not every student makes the transition successfully. Severe psychiatric disorders such as bipolar disorder and schizophrenia typically first manifest themselves between the ages of 18 and 24 years and can easily derail the lives of students. Major depression, posttraumatic stress disorder and personality disorders also can be extremely disruptive.
Sleep deprivation is a hallmark of the college experience. It is also a major trigger of mania, which increases the odds of depression, mixed states and suicide (Jamison, 1999). Unfortunately, the boundless energy and creativity that often accompany mania are sought-after qualities by many colleges and universities. Consequently, students may be in serious, if not life-threatening, crisis before they or others recognize the need for psychiatric intervention.
"People assume that many behaviors that are, in fact, symptomatic of serious mental illness are part and parcel of normal adolescence," said Kay Redfield Jamison, Ph.D., in an interview with PT. "This is understandable but potentially dangerous," said Jamison, who has bipolar disorder and attempted suicide at age 28, years after beginning to struggle with symptoms of the disease.
Jamison believes that parents and prospective students should inquire into the availability of good mental health care services, regardless of whether a student has a diagnosed mental illness. "People should be well-informed when they apply," she said. "It's a high-risk time."